Provider Demographics
NPI:1891408191
Name:MONTGOMERY PAIN INSTITUTE PC
Entity Type:Organization
Organization Name:MONTGOMERY PAIN INSTITUTE PC
Other - Org Name:CLARKSVILLE PAIN INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:931-802-6824
Mailing Address - Street 1:1849 MADISON ST STE F
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5281
Mailing Address - Country:US
Mailing Address - Phone:931-802-6824
Mailing Address - Fax:
Practice Address - Street 1:1849 MADISON ST STE F
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5281
Practice Address - Country:US
Practice Address - Phone:931-802-6824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-02
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty